The potential for infant or child strangulation and/or asphyxia in the home environment is well documented in the health care literature (Drago et al., 1999, Pediatrics 103: 59-71; Nakamura et al., 2003, Pediatrics 111: 12-16; Scheers et al., 2003, Pediatrics 112 : 883-889). Strangulation by entanglement is the sixth leading cause of infant mechanical suffocation in the United States (Drago et al.), while in Canada, 19 per 100,000 deaths were attributed to suffocation in the 0 to 4 years age group (Beaulne, 1997, ‘For the Safety of Canadian Children and Youth: From Inury Data to Preventative Measures’, Health Canada Publ.).
Children in hospitals are also at risk for strangulation or asphyxia caused by entanglement. The risk is directly associated with tubings and lines associated with the delivery of intravenous fluids, oxygen therapy, cardiorespiratory monitoring, and other treatments and diagnostic techniques (Garros et al., 2003, Pediatrics 111: 732-734). The percentage of hospitalized pediatric patients who receive intravenous (IV) therapy is significant. The length of IV tubing varies between 2.1 and 2.7 meters to accommodate the distance from the patient in the bed/crib to the IV pump (used to maintain even rates of fluid administration) which is similar to the lengths of blind or window cords, and therefore, IV tubing is also a significant risk factor for infant entanglement and strangulation. Depending on fluid requirements and drug therapy, an infant or child may have several tubing lines leading to multiple pumps, as well as oxygen or other monitoring or therapeutic tubes or lines. Reports of children dying in hospital by strangulation via tubing and monitor wires are found in the literature (Garros et al.). Further, nurses describe finding children entangled in tubing, however are unlikely to report the occurrence unless harm is identified. Although the incidence of tubing entanglement is largely unknown, the potential consequences of serious injury and death are unacceptable. The population at risk is identified as infants between 3 and 36 months as well as cognitively incapacitated children, adolescents and adults.